How I Got Here- NICU & Pediatrics

Happy Monday, folks! Today we are taking a break from making and instead continuing our journey through my story. As you may recall, our story left off with my experiences with home care nursing shortly after leaving school. You can find the previous posts HERE in case you missed one.

I left home care nursing after having one of those “final straw” types of days. I left my shift, called the office and gave my resignation- no plan in place. Sound familiar? Apparently I am developing a track record *wink*. It may sound stupid to some or brave to others. Really it was neither. It was a cumulation of emotional exhaustion and the realization that I just couldn’t do it any more for my own mental health.

Shortly after, I saw an add looking for NICU & Pediatric nurses at the local hospital. I had vowed never to work in a hospital following my clinical experiences, but desperation and pessimism were prevalent. I mean, what could really be worse than what I had just left? And you know what? It was my favorite job. I was still very young, looked much younger (which believe me I never heard the end of from patients and their families), and completely and utterly terrified. The nurses there were the kindest, most supportive people I had ever met. More than one went out of there way to make me comfortable, teach me and guide me and help me to grow. I honestly felt like maybe there was something in the water. After all, everyone was so NICE. Maybe too nice… I made some really great life long friends there.

NICU was by far my favorite. Perhaps it’s the routine of the unit that made it more comfortable. With anywhere from 3-4 fairly stable babies who eat every 2-3 hours it’s like a round-robin of sorts. Of course, there was always that apnea spells (where a baby stopped breathing and sometimes required intervention) or bradycardia spells (where a baby’s heart rate dropped dramatically) to bring a bit of action to the day. There were also the long, 12 hour night shifts where the crying was incessant & I had to admit that it was at least conceivable to me what could make a parent snap and shake a baby (though not condonable!) I loved the ability to work directly with parents one on one and teach; we helped with everything from teaching about the importance of babies sleeping on their backs and general baby care, to breast feeding, to helping parents recognize baby cues while learning to eat.

Of course, it wasn’t always a cake walk. There were the times that a parent would be banned from the hospital grounds for threatening staff; there were the mothers who were obviously being abused at home coming to grips with whether or not to take their baby back home to that or risk getting out; there were parents with scary and damaging mental health issues that we couldn’t prevent from taking home their child; there were the mothers who had several kids removed from their care already due to abuse/neglect but were always given another chance because they hadn’t yet proved harm to this particular child; there were mothers who will still children themselves; there were mothers who’s drug addiction was responsible for their baby being born at 23 wks and struggling for it’s life; and maybe worst of all, the mothers that just weren’t there.

When the life of an innocent is involved it can make people heated and hateful. It’s easy to say things like, “How can she be so stupid to stay?!” or “Why should she get to take this one home? She’s only going to hurt this one as well!” or “another welfare baby we have to pay for” or “She did this to her baby. She should be drug out into the street and shot.” I won’t lie. I didn’t always argue even in my heart. I sometimes agreed and helped to lead the mob. Then my co-worker, Kristy, said something to me that would forever change me, “Our most important job is to help these mothers to bond with their baby. It is only by loving their baby that we can hope to change anything.” I left miffed that day like a toddler that had been reprimanded, but as I sat with it it sunk in and took hold. It was true. We couldn’t undo any damage that had already been done. What we could do was help to influence the future.

It was that statement that got me thinking about what it meant to be empathetic. To walk in another person’s shoes. Nobody wants to be in an abusive relationship- instead we accept the love we think we deserve. What makes that woman think she’s no better than that? After all he’s done already what’s to convince her that he won’t really kill her just like he said he would? Where are we gonna be after she leaves him? Nobody wants to become a drug addict, but something drove them there. What hurt happened to this person to make them want to hide it, cover it up, try to drown or destroy it? What powerful hold does it have on them that knowing they are harming their child isn’t enough to stop them? To know that destroying themselves doesn’t cause them to even blink? That they are willing to give up all that they love and hold dear? And would I be any different had those horrors happened to me? I can’t say that I would. I had my own struggles when I was young and tried desperately to drown them out, as well. I had many days in which death seemed a reasonable alternative to pain. I was strong enough, just enough, to overcome. I met someone I loved enough to save me. But what if I hadn’t?

It was about two years into the job before I saw my first death. Babies on the unit had died before, but this baby died right next to me. The unit, at the time, was broken into 3 large rooms that held up to 8 babies that were separated merely by curtains when privacy was needed. That day the room was full. I was working alongside one of my favorite nurses who was a NICU veteran and was caring for the baby in question. That day we knew all shift that it was only a matter of time. The baby had been born extremely early and had many health issues include significantly underdeveloped lungs and a large amount of bleeding in his brain. His mother was alone in the world and dealing with the reality that some of her life choices had brought her to this. She came down early, before other parents had arrived, to hear from the doctor that there wasn’t anymore that we could really do and that death at this point was inevitable. She was told that we could try to save her baby but he would most likely die without her ever having the chance to hold him or she could choose to let him go and be there beside him and to hold him as he went. This was a choice that needed much thought and after a bit she left. She finally returned later in the day, the unit now full of parents and visitors, having made the choice to hold her child. I remember being on the other side of the curtain helping a mother of a baby who had been in the unit a few months by this time, who’s baby had survived and started to thrive. We were giving the baby a bath and getting her dressed when we heard a wail, a scream of the likes I have never heard, even to this day. It was a cry of such pain that even today I still get goosebumps. A primal wail that to this day admittedly gives this veteran nurse goosebumps. It was the most heartbreaking thing I had ever heard and there was not a dry eye on the unit. We cried in silence along with her. I remember the woman I helped speaking of her guilt in having a baby that lived. I remember the stoic teenage mother no one could reach holding her child a little tighter that day.

After all was said and done, the unit emptied and we took time to bathe, dress and photograph the child should his mother change his mind and want this reminder. We made a plaster cast of his tiny foot inside of a seashell. That was all she was left with beside a heart full of guilt and empty arms.

And as nurses and physicians, many people judged her. Condoned her. Luckily I had met Kristy who helped me to love her that day and hope that if nothing else this love, though very brief, could save her.

Unfortunately, death is never far away, even for children. Sometimes it’s caring for them without them yet knowing that the car crash that put them in the hospital killed one of their parents. Sometimes it’s hovering near the door of the latest school shooting victim. Sometimes it’s the surprise death of a patient that took a very sudden turn for the worst. Sometimes it’s in the eyes of the the teenager still battling cancer year after year but knows she’s losing. It’s these things that have made it hard for me to believe in a loving God or a greater plan. It’s easy to believe in the devil when you see him everyday.

But God was there in the smiles of all the kids that were saved. Because despite the horrors (and these are just a sprinkling of what I saw) kids were saved every day. Kids were placed in foster care and given a second chance and their mother’s the help to straighten up. They didn’t always take it, but sometimes they did and they succeeded. HE was there helping us make differences we would never know about until months or years later when we would get a card or a letter or a visit to the unit. I know that there were so many more that we never knew about and that went unrecognized. That was never why we did it, anyway. I still run into people that remember me so many years later, their kids now teenagers, and it fills my heart. Miracles are everywhere.

I was there for 8 years and like all jobs, the political tides shift, people come and people go, management changes, but ultimately, had my job not been eliminated I might still be there. The hospital eventually shifted away from using LPNs on that floor. The tides ebb and flow in this area throughout the years. One year they are fazing us out then a few years later we come back. It’s hard. It’s hard to know that you do good work, that you are valuable but it goes unseen. As we were being fazed out I could tell the new grads that were hired by their opinions of us. That it was their license on the line and as far as we were concerned we were more of a liability than a help. That they were responsible for doing everything so you wouldn’t fuck up. Forgetting in all of it that I had 10+ years of experience. That I had seen with my own eyes what respiratory distress looked like and not just read about it. That I had my own license, too, and that my fuck ups were just that- mine. Had I not been fazed out I might still be there, but probably not. It seems that all of this junk, the distrust, the feeling of being unappreciated, of being unsupported is so much more detrimental to one’s mental health than the death and the sadness. Put them both together and it’s a hard atmosphere for anyone to excel in.

2 Responses

What an amazing part of your history! 🙂 My little sis was a NICU baby for several months after her birth. My family knows that setting very well. NICU nurses are special sorts of people, so giving and loving in the wake of touch situations.

I feel weirdly blessed to have had my twin girls in the NICU so that I had the chance to experience it from both sides. I just wish that their being there had come first. I think it could only have made me better.